Oral arguments begin Tuesday, with three conservative justices appointed by outgoing President Donald Trump joining the 6-3 conservative court to decide the case. 

The US Supreme Court, with its newly bolstered 6-3 conservative majority, will hear oral arguments Tuesday in a case backed by outgoing President Donald Trump that could end up striking down the entire Affordable Care Act and stripping health insurance away from as many as 224,000 Wisconsinites.

The landmark Affordable Care Act, commonly referred to as Obamacare, has been a target throughout Trump’s term. Even in the middle of a pandemic that has infected 9 million Americans and killed 236,000, the soon-to-be-former president—obsessed with undoing predecessor Barack Obama’s accomplishments—is backing a lawsuit led by Republican attorneys general that would kill the entire law.

The Center for American Progress estimates 224,000 Wisconsinites and 23 million Americans would lose health insurance if the ACA is overturned. 

The Supreme Court has repeatedly declined to strike down the ACA, Obama’s signature achievement. The presence of newly confirmed Supreme Court Justice Amy Coney Barrett, who filled the seat vacated by the late Ruth Bader Ginsburg, offers no guarantees the law will be upheld this time. Trump, who appointed one-third of the whole court during his single term in office, used opposition to the ACA as a litmus test for his appointees.

The ACA includes several incredibly popular provisions that protect people’s health care, such as prohibiting insurance companies from denying coverage to people with pre-existing conditions, allowing young adults to stay on their parent’s insurance until age 26, and prohibiting insurance companies from instituting lifetime coverage caps.

Protect Our Care, an organization dedicated to defending the ACA, estimates as many as 2.4 million Wisconsinites with pre-existing conditions could lose coverage without the legal protections afforded by the ACA. Another 41,000 young adults on their parents’ insurance would be at risk as well, according to Protect Our Care.

Nationwide, 130 million Americans have pre-existing conditions, meaning as much of a third of the country would be at risk of losing coverage without the ACA.

Gov. Tony Evers is scheduled to join a virtual panel defending the ACA on Tuesday as arguments begin.